what's driving off the fiscal cliff look like? it makes us look completely irresponsible as if we can't control our own spending and put in order some priorities. >> so some health care will be suffering? >> that's absolutely true. we want to incentive doctors ask hospitals to keep people well. not to just do procedures. and that's the key to really transforming medicare. >> i want to show you a map of the states that are refusing to implement the insurance exchanges. it's rather interesting. the other states are either implementing the exchanges or haven't decided to do that. if states don't decide to do it and the federal government comes in and sets up the exchange, isn't that kind of a win for the move towards universal health care because the infrastructure will be there? >> i think it provides people an option whether governors are refusing or not. that's the most important thing so they can get access to insurance products. also i think, you know, it takes away the claim that the federal government is u surping health care.